The Changing Hearing Healthcare Landscape
|
|
- Gilbert Miles
- 8 years ago
- Views:
Transcription
1 The Changing Hearing Healthcare Landscape Robert Burkard, Ph.D. CCC-A Professor and Chair Rehabilitation Science University at Buffalo Disclaimers: Robert Burkard is a member of The American Speech-Language Hearing Association (ASHA) Health Care Economics Committee, was an organizer and participant in ASHA s 2012 Healthcare Summit, a member of the Audiology Quality Consortium, and was the Chair of ASHA s ad hoc Committee on Interprofessional Education.
2 Cost Containment for Health Care Multiple organizations are recommending going away from a Fee for Service model and replacing it with Value Based Purchasing Value should always be defined around the customer, and in a well-functioning health care system, the creation of value for patients should determine the rewards for all other actors in the system. Since value depends on results, not inputs, value in health care is measured by the outcomes achieved, not the volume of services M. Porter, What is Value in Health Care? NEJM, 2010, 363: Fee for service: o Encourages increased utilization o More services results in more payment, but raises the issue of the true medical necessity for these increased services
3 Audiology & Value Based Purchasing The potential biggest impact will be working to identify procedure groups to bundle such as the changes in audiometric, immittance and vestibular testing bundled CPT codes: 92557: Comprehensive Audiometry Threshold evaluation and Speech Recognition 92570: Acoustic Immittance Testing (tympanometry, acoustic reflex threshold, acoustic reflex decay) 92540: Basic Vestibular Evaluation (spontaneous nystagmus, positional nystagmus, optokinetic nystagmus, foveal and peripheral stimulation) One could envision further efforts along these lines. So in effect paying for a group of diagnostic procedures with a single payment the group of procedures is to result in diagnostic AND functional information.
4 Unbundling (This is a contentious issue): Hearing Aids are not covered by Medicare or most private insurance companies. Audiologists frequently sell a hearing aid bundled with their services: The device Earmold Assessment (unaided, real ear measure, behavioral gain) Batteries Repair/earwax removal Counseling Aural rehabilitation Online and other (similar) hearing aid sales typically provide the device, but not the above-listed services, and are substantially cheaper than when the hearing aid is bundled with the above-listed services. Practices need to have a plan on how to work with these patients. Unless one unbundles, any service you give away (or appear to give away) which might be billable to Medicare (including threshold estimation) must be done for free for all patients. Thus, if a patient buys a hearing aid online, then asks you to provide the other services for free, you might be obligated to do so.
5 How Does One Code for Outcome? Another phase of the overall change in the hearing healthcare landscape is the change to ICD 10 coding: o October 1, 2014: International Classification of Diseases, 9 th Revision, Clinical Modification ICD-10-CM o ICD-9-CM approximately 18,000 codes, while ICD-10- CM approximately 160,000 available codes provides more specificity than ICD-9-CM: Noise-induced hearing loss due to dolphin encounter (initial encounter): H83.3X3- Noise effects on inner ear, bilateral W56.09Xa- Other contact with dolphin o ICD-10-CM could be used with the International Classification of Functioning, Disability & Health (ICF) for coding level of severity (i.e., 0 is no problem while 4 is complete problem )
6 Brief ICF Core Set for Hearing Loss: Body Functions (7): Temperament and Personality Functions Attention Functions Memory Functions Emotional Functions Seeing Functions Hearing Functions Sensations Associated with Hearing and Vestibular functions Environmental Factors (7): Products and Technology for Communication Sound Immediate Family Health Professionals Individual Attitudes of Immediate Family Members Societal Attitudes Health Services, Systems and Policies Body Structures (4): Structure of the Brain Structure of the External Ear Structure of the Middle Ear Structure of the Inner Ear Activities and Participation (9): Listening Handling Stress and other Psychological Demands Communicating with- receiving- Spoken Messages Conversation Using Communication Devices and Techniques Family Relationships School Education Remunerative Employment Community Life
7 Physician Quality Reporting System (PQRS) CMS designed PQRS to improve quality of care for Medicare beneficiaries Since 2007, quality reporting has been voluntary for services to Medicare Part B Fee for Service beneficiaries The Patient Protection and Affordable Care Act (PPACA) includes transition from incentive for participation in PQRS to penalty for nonparticipation There are currently few measures specific to audiology
8 Why Should Providers Participate in PQRS?: It is all about reimbursement To avoid 2% penalty, in 2014 must report on 50% of qualifying patients for three measures (or as many as are available) To receive 0.5% incentive, must report on 50% of qualifying patients for 9 measures including 3 quality domains* (or as many as are available) *Quality domains: Patient Safety; Person and Caregiver-Centered Experience and Outcomes; Communication and Care Coordination; Effective Clinical Care; Community/Population Health; Efficiency and Cost Reduction Instruments/PQRS/Downloads/July_25_2013_National_Provider_Call_Presentation.pdf
9 Measure Development: Audiology Quality Consortium (AQC): 10 Audiology organizations* Inclusion in current PQRS measures: Referral for dizziness Smoking cessation counseling Blood pressure measurement Pain assessment Falls prevention Currently drafting 6 measures for future use (and considering more): Speech-in-noise testing for CI referral Functional communication ability Tinnitus screening/evaluation (2) Ototoxic baseline measurement/monitoring Vestibular testing *Academy of Doctors of Audiology, Academy of Rehabilitative Audiology, American Academy of Audiology, American Academy of Private Practice in Speech Pathology and Audiology, American Speech-Language-Hearing Association, Association of VA Audiologists, Directors of Speech and Hearing Programs in State Health and Welfare Agencies, Educational Audiology Association, Military Audiology Association, National Hearing Conservation Association
10 PPACA Essential Health Benefits to be covered by Exchanges and Medicaid programs 10 categories of covered service areas: Ambulatory patient Services Emergency Services Hospitalization Maternity and newborn care Mental Health and substance use disorder services Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventative and wellness services and chronic disease management Pediatric services, including oral and vision care N. Tate (2013) ObamaCare Survival Guide. The Affordable Care Act and What it Means for You and Your Healthcare. Humanix Books: West Palm Beach, Florida
11 Essential Health Benefits If hearing services are not specifically listed as an essential health benefit, it seems highly unlikely they will be included individually in an ACO structure What is needed to make Hearing services essential? Evidence must show that diagnostic and therapeutic hearing services make a significant difference in the outcomes of the patients, and does so in a cost effective manner (i.e., we must be able to demonstrate our Value ).
12 Hearing healthcare providers do not play well with one another: Despite evidence (e.g., Zapala et al. 2010) that audiologists are able to diagnose hearing conditions associated with significant morbidity and mortality (and thus make appropriate medical referrals), AAO-HNS quite strongly opposes Direct Access for Audiology. In light of this opposition, it is unlikely that a bill about direct access for audiology (proposed by the American Academy of Audiology) will be supported: Representative Mike Ross (D-AR) has introduced the Medicare Hearing Health Care Enhancement Act of 2011 (H.R. 2140), along with 11 original co-sponsors. H.R eliminates the need for Medicare patients to obtain a physician referral prior to visiting an audiologist for an evaluation. Federal employees and members of Congress also have direct access to an audiologist. This bill would afford Medicare patients the same direct access to an audiologist.
13 Audiology: Internecine Battles: AAA: Direct Access ASHA: Comprehensive Medicare Coverage for Audiology Services: Overview of H.R The Medicare Audiology Services Enhancement Act of 2013 More Information H.R moves audiology forward in the current health care system by recognizing audiologists as diagnostic and treatment providers, able to receive Medicare reimbursement for professional services provided; increases access to care by allowing Medicare beneficiaries to receive diagnostic and treatment services from audiologists ADA (Academy of Doctors of Audiology): Audiology s 18 by 18 Campaign Aims to Achieve Limited License Physician Status, Direct Access and Expanded Audiology Benefits under Medicare: Allow for Medicare coverage of medically necessary, covered treatment services such as vestibular rehabilitation, cerumen removal, and aural rehabilitation provided by an audiologist practicing within their state defined scope of practice. Eliminate the need for the physician order required for a Medicare beneficiary to receive coverage of medically necessary, covered audiology and vestibular services Allow audiologists the autonomy to make clinical recommendations and practice the full scope of audiology and vestibular care as allowed by their state license and as dictated by their educational requirements and competencies.
14 My Personal Opinion: If we want to make it possible for more elders to live independently longer, to reduce medical non-compliance because those elders with hearing loss do not understand what their physician is telling them, and to improve their quality of life, we must support legislation that mandates that Medicare cover the costs of hearing aids, and allow audiologists to be reimbursed for their (re)habilitative services.
15 Interprofessional Education (IPE) When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (World Health Organization, 2010) 2013 Cochrane Review (Reeves, Perrier, Golsman, Freeth and Zwarenstein, 2013): 15 studies that met inclusion criteria..due to small number of studies and heterogeneity of interventions and outcome measures, it is not possible to draw generalizable inferences about the key elements of IPE and its effectiveness. Need to compare effectiveness of IPE interventions to discipline-specific Interventions The Bottom Line: We need more evidence that IPE leads to better value in healthcare delivery.
16 Research Areas: 1. The audiogram is not an optimal functional measure of hearing. Studies investigating hearing-related disability should use hearing handicap scales and/or speech-in-noise measures. 2. We must move away from a disease-based scale of hearing loss (e.g., ICD-10) to a functional-based scale (e.g., ICF). The ICF core set and brief core set of hearing loss should be considered as measures of severity of hearing loss, quality of life, as well as quality of care metrics. 3. We have no good site-of-lesion tests to separate our the many causes of sensorineural hearing loss (e.g., strial, inner hair cell, synaptic, neural). 4. There are both strengths and limitations to correlational research: A correlation between hearing loss and dementia does not mean that treating the hearing loss will reduce the incidence of dementia. We need data that suggests that there is VALUE in adult hearing loss screening. 5. Medicare is broken, and needs to be fixed. Specifically, our valuation system for CPT codes (by the RUC and RUC HCPAC) is at best flawed and at worse biased (in part due to AMA involvement in the process). 6. Funded pilot studies should investigate the value of direct access for audiologists, and what happens to quality of care when audiologists are reimbursed by Medicare to provide (re)habilitative services.
17 Acknowledgements: ASHA Health Care Economics Committee The Audiology Quality Consortium ASHA ad hoc Committee on Interprofessional Education Those who attended the 2012 ASHA Changing Health Care Landscape Summit Bob Fifer Mark Parker Stu Trembath Lisa Satterfield Neil Shepard
Official CPT Description
s CPT 69210 Removal impacted cerumen (separate procedure), one or both ears 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual 92516 Facial nerve
More informationAudiology: A Profession in Transition
The Field of Audiology Audiology: A Profession in Transition Wayne A. Foster, PhD, CCC-SLP/A Chair, Audiology Advisory Council ASHA Board of Directors Heritage of Audiology What Makes Audiologists Unique?
More informationHealth Care Economics and Audiology: Why are WE Feeling the Pain? Disclosures. Disclosure 1/6/2016
Health Care Economics and Audiology: Why are WE Feeling the Pain? Robert Fifer, Ph.D. University of Miami Miller School of Medicine Mailman Center for Child Development Disclosures Employed by the University
More information2016 Medicare Fee Schedule for Audiologists. American Speech-Language-Hearing Association
2016 Medicare Fee Schedule for Audiologists American Speech-Language-Hearing Association 1 st Edition November 10, 2015 General Information This document was developed by the American Speech-Language-Hearing
More informationMODEL SUPERBILL for AUDIOLOGY
MODEL SUPERBILL for AUDIOLOGY The following is a model of a superbill which could be used by an audiology practice when billing private health plans. This sample is not meant to dictate which services
More informationReporting Audiology Quality Measures: A Step-by-Step Guide
What is PQRS? The Physician Quality Reporting System (PQRS) is a program through the Centers for Medicare and Medicaid Services (CMS) designed to improve the quality of care to Medicare beneficiaries by
More informationHow To Oppose The Audiology Patient Choice Act
ISSUE BRIEF Know the Facts About the Audiology Patient Choice Act May 2015 Introduction Recently, the American Academy of Otolaryngology-Head Neck Surgery (AAO-HNS) issued a statement 1 to its members,
More informationComprehensive Audiology Medicare Benefit Good for Audiology? Vic S. Gladstone, Steven C. White, Colleen O Rourke, George O. Purvis
Comprehensive Audiology Medicare Benefit Good for Audiology? Vic S. Gladstone, Steven C. White, Colleen O Rourke, George O. Purvis Presentation Outcomes participants will be able to describe coverage policies
More information2015 Medicare Fee Schedule for Audiologists. American Speech-Language-Hearing Association
2015 Medicare Fee Schedule for Audiologists American Speech-Language-Hearing Association 3 rd Edition July 27, 2015 Summary of Revisions April 17, 2015 (2 nd Edition) Page 4: Overview (Updated to reflect
More informationICD-10 Coding for Audiology
ICD-10 Coding for Audiology Mary Sue Fino-Szumski, Ph.D., M.B.A. Vanderbilt University School of Medicine Vanderbilt Bill Wilkerson Center Department of Hearing and Speech Sciences Disclosure Financial
More information4. PROGRAM REQUIREMENTS
TABLE OF CONTENTS iv 4. PROGRAM REQUIREMENTS 413.401: Introduction... 4-1 413.402: Definitions... 4-1 413.403: Eligible Members... 4-3 413.404: Provider Eligibility... 4-3 413.405: Services Provided by
More informationBilling, Coding, & Calculating Fees: Finding Success
Billing, Coding, & Calculating Fees: Finding Success Janet McCarty American Speech-Language-Hearing Association Today s Agenda BILLING: Learn how to bill for your services. CODING: Learn the codes that
More informationCHAPTER 30. MEDICAL PROVIDERS-FEE FOR SERVICE SUBCHAPTER 5. INDIVIDUAL PROVIDERS AND SPECIALTIES PART 103
CHAPTER 30. MEDICAL PROVIDERS-FEE FOR SERVICE SUBCHAPTER 5. INDIVIDUAL PROVIDERS AND SPECIALTIES PART 103. QUALIFIED SCHOOLS AS PROVIDERS OF HEALTH RELATED SERVICES 317:30-5-1023. Coverage by category
More informationACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO)
ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) Introduction and background: Summarizes the essential benefit package
More informationCPT Tips. Modifiers. Use of 92700. Modifiers. Modifiers 3/4/2013. Solutions for the Most Common and Problematic Coding and Reimbursement Issues
Solutions for the Most Common and Problematic Coding and Reimbursement Issues Kim Cavitt, AuD Audiology Resources, Inc. Indiana Speech and Hearing Association April 6, 2013 CPT Tips Always have the coding
More informationCMS 1590-P: Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2013
August 31, 2012 Marilyn Tavenner Acting Administrator and Chief Operating Officer Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1590-P P.O. Box 8013
More informationChapter. Funding for Treatment of Hearing Impairments
. Chapter Funding for Treatment of Hearing Impairments Chapter 5 Funding for Treatment of Hearing Impairments Hearing services and devices are paid for directly by hearing impaired people or by private
More informationIt goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.
WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals
More informationLegs/Regs. Basic Medicare rules. Quality. Audits
SPEAKER DISCLOSURE SHOWCASING VALUE: MAXIMIZE PAYMENT FOR AUDIOLOGY SERVICES Lisa Satterfield, M.S., CCC-A ASHA director of health care regulatory advocacy Lisa Satterfield, M.S., CCC/A is ASHA's director
More information10/23/09 NewProgram-AuD-2009
AUDIOLOGY Type of program you would like to see: Describe. We are proposing a clinical doctorate program in audiology that meets the 2007 certification standards of both the American Speech-Language and
More informationAudiologist and Hearing Aid Dispenser. Provider Manual
Audiologist and Hearing Aid Provider Manual Provider 1 TABLE OF CONTENTS Chapter I. General Program Policies Chapter II. Member Eligibility Chapter IV. Billing Iowa Medicaid Appendix III. Provider-Specific
More informationA PROFESSIONAL PRACTICE PROFILE
A PROFESSIONAL PRACTICE PROFILE FOR HEARING HEALTH PROFESSIONALS The International Hearing Society has adopted the following practice profile as a comprehensive declaration of dispensing characteristics
More informationCoding Fact Sheet for Primary Care Pediatricians
1/1/2015 Hearing Testing Coding Fact Sheet Coding Fact Sheet for Primary Care Pediatricians While coding for hearing screening is relatively straightforward, ensuring that appropriate payment is received
More informationScope of Practice in Audiology
Ad Hoc Committee on in Audiology Reference this material as: American Speech-Language-Hearing Association. (2004). in Audiology []. Available from www.asha.org/policy. Index terms: scope of practice doi:10.1044/policy.sp2004-00192
More informationChapter 41 Speech-Language Pathology and Audiology Licensing Act
Chapter 41 Speech-Language Pathology and Audiology Licensing Act 58-41-1 Title of chapter. This chapter is known as the "Speech-language Pathology and Audiology Licensing Act." 58-41-2 Definitions. In
More informationHearing Aids - Adult HEARING AIDS - ADULT HS-159. Policy Number: HS-159. Original Effective Date: 3/18/2010. Revised Date(s): 3/18/2011; 3/1/2012
Harmony Behavioral Health, Inc. Harmony Behavioral Health of Florida, Inc. Harmony Health Plan of Illinois, Inc. HealthEase of Florida, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance
More informationNebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session. August 16, 2012
Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session August 16, 2012 TODAY'S AGENDA Section 1: Review of Health Insurance Exchanges Section 2: Overview of Essential
More informationPatient: A 65-year-old male who is a Medicare Part B beneficiary, whose testing was ordered by his internist
The following examples are to assist you with PQRS reporting. These examples were created in collaboration with the Academy of Doctors of Audiology and the American Speech-Language-Hearing Association
More informationHealth Insurance Exchange & Network Management Solutions
Health Insurance Exchange & Network Management Solutions Mike Flanagan AVP, Product Management June 19, 2013 Today s Presenter Mike Flanagan Associate Vice President of Product Management McKesson Health
More informationI. Insurance Reforms and Expansion of Coverage. Implementation Date Plan years beginning on or after six months after passage of the Act.
University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) Summary of Selected Tobacco, Prevention, and Public Health Provisions from H.R. 3590, the Patient Protection and Affordable
More informationFREQUENTLY ASKED QUESTIONS REGARDING SCHOOL AUDIOLOGY SERVICES
FREQUENTLY ASKED QUESTIONS REGARDING SCHOOL AUDIOLOGY SERVICES The purpose of this document is to respond to questions concerning the role and responsibilities of educational audiologists and how they
More informationREGULATIONS FOR THE DEGREE OF MASTER OF SCIENCE IN AUDIOLOGY (MSc[Audiology])
224 REGULATIONS FOR THE DEGREE OF MASTER OF SCIENCE IN AUDIOLOGY (MSc[Audiology]) (See also General Regulations) Any publication based on work approved for a higher degree should contain a reference to
More informationRules of the Engagement: Compliance, Legalities and Ethics in Audiology Today. 2011 AAA Convention Chicago, IL
Rules of the Engagement: Compliance, Legalities and Ethics in Audiology Today 2011 AAA Convention Chicago, IL 1. Ignorance is NOT a defense 2. Rules, regulations, guidance and laws do not have to be interpreted
More informationNEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES PROCEDURE CODES
NEW YORK STATE MEDICAID PROGRAM HEARING AID/ AUDIOLOGY SERVICES PROCEDURE CODES Table of Contents WHAT S NEW FOR THE 2016 MANUAL? --------------------------------------------------------------------------------
More informationAudiologic/Aural Rehabilitation: Reimbursement Issues for Audiologists and Speech- Language Pathologists
Audiologic/Aural Rehabilitation: Reimbursement Issues for Audiologists and Speech- Language Pathologists What is covered here New audiologic/aural rehabilitation (AR) codes Role of audiologists and SLPs
More informationAFFORDABLE CARE ACT FAQ
AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want
More informationAudiologist. Practice area 179. Background
Practice area 179 Clinical PRIVILEGE WHITE PAPER Audiologist Background Audiologists diagnose, treat, and manage patients who have hearing, balance, and related ear problems. They work with patients of
More informationProvider Billing Communication Federally Qualified Health Center Services (FQHC)/Rural Health Clinic (RHC)
Provider Billing Communication Federally Qualified Health Center Services (FQHC)/Rural Health Clinic (RHC) WellCare of Georgia will be paying Federally Qualified Health Centers (FQHC) and Rural Health
More informationHow To Train An Audiologist
Indian Speech and Hearing Association Scope of Practice in Audiology & Speech-Language Pathology Statement of Purpose This document, drafted by the Indian Speech Language and Hearing Association (ISHA),
More informationMedicare taxes on higher income families $318. Cadillac tax on high-cost plans $111. Employer mandate $106
ACA Changes Created new way of counting Medicaid income Removed asset tests for some Medicaid groups Increased Medicaid income levels for children Raised age limit for coverage of children who age-out
More informationDoctor of Audiology Transitional Degree Program. Distance Education for Practicing Audiologists. Au.D. Curriculum Guide
Doctor of Audiology Transitional Degree Program Distance Education for Practicing Audiologists Au.D. Curriculum Guide Doctor of Audiology Transitional Program Currriculum Guide Course Descriptions Modules
More informationProgram Objectives 9/2/2014. Affordable Care Act: Smooth or White Waters Ahead? History of Healthcare Reform
Affordable Care Act: Smooth or White Waters Ahead? Kathleen Bradbury-Golas, DNP, RN, NP-C, ACNS-BC Assistant Professor, Felician College Family Nurse Practitioner, Virtua Atlantic Shore Family Practice
More informationThe American Academy of Audiology. Response to the AMA Scope of Practice Data Series: Audiologists (April 2009)
The American Academy of Audiology Response to the AMA Scope of Practice Data Series: Audiologists (April 2009) Task Force Members: Georgine Ray, AuD, Academy Board Member, Task Force Chair Debra Abel,
More information[Adapted from Fed. Reg. 52530; NAIC Glossary of Health Insurance and Medical Terms: 3]
New York State Benchmark Plan Recommendations Introduction The Patient Protection and Affordable Care Act (ACA) includes Rehabilitative and Habilitative Services and Devices as one of the ten categories
More informationApril 30, 2014. Federal Trade Commission Office of the Secretary Room H-113 (Annex X) 600 Pennsylvania Avenue, NW Washington, DC 20580
April 30, 2014 Federal Trade Commission Office of the Secretary Room H-113 (Annex X) 600 Pennsylvania Avenue, NW Washington, DC 20580 VIA ELECTRONIC SUBMISSION RE: Health Care Workshop, Project No. P131207
More informationOtotoxicity Monitoring
Ototoxicity Monitoring Aaron Jones, Au.D., M.S. Doctor of Audiology May 12, 2011 Agenda Background Antineoplastic ototoxicity monitoring Case study Company overview Gross Anatomy of the Ear Image: http://en.wikipedia.org/wiki/file:anatomy_of_the_human_ear.svg
More informationTHE AFFORDABLE CARE ACT AND DENTAL COVERAGE IN ILLINOIS
THE AFFORDABLE CARE ACT AND DENTAL COVERAGE IN ILLINOIS Stephanie F. Altman Health & Disability Advocates www.hdadvocates.org www.illinoishealthmatters.org Health & Disability Advocates Based in Chicago
More informationHearing Screening Coding Fact Sheet for Primary Care Pediatricians
Hearing Screening Coding Fact Sheet for Primary Care Pediatricians While coding for hearing screening is relatively straightforward, ensuring that appropriate payment is received for such services is a
More informationWashington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin
Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin The Washington State Health Care Authority (HCA) is pleased to submit comments
More informationSpeech-Language Pathology, Audiology and Hearing Aid Services Rulebook
Health Services Office of Medical Assistance Programs Speech-Language Pathology, Audiology and Hearing Aid Services Rulebook Includes: 1) Current Update Information (changes since last update) 2) Table
More informationTimeline of New Health Care Law and Its Impact on American Businesses
Timeline of New Health Care Law and Its Impact on American Businesses Summaries of the Patient Protection and Affordable Health Care Act (Public Law 111-148) Health Care and Education Reconciliation Act
More informationSenate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**
Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening
More informationA Guide to Otoacoustic Emissions (OAEs) for Physicians
A Guide to Otoacoustic Emissions (OAEs) for Physicians Introduction Hearing loss is not uncommon in children and adults. According to recent estimates, 31.5 million people in the United States report difficulty
More informationPAs and Provisions of Health. What does it Mean to You?
PAs and Provisions of Health Reform What does it Mean to You? Presentation to the South Dakota Academy of Physician Assistants March 7, 2013 Liz Roe, Director, Constituent t Organization Outreach and Advocacy
More informationUsing Social Media Tools to Enhance Your Professional Development and Online Presence by Allison Bland
Using Social Media Tools to Enhance Your Professional Development and Online Presence by Allison Bland Allison Bland is ASHA s Online Community and Social Media Manager. She is interested in making health
More informationSCOPE OF PRACTICE POSITION STATEMENTS TABLE OF CONTENTS
SCOPE OF PRACTICE POSITION STATEMENTS TABLE OF CONTENTS BOTH PROFESSIONS ASHA Certificate of Clinical Competence Foreign-Trained Applicants Policy for Doctorate Degree Representations License Renewal Notices
More informationUnderstanding Coding & Reimbursement for SBI. Presented By: Jen Cohrs CPC, CPMA, CGIC Director of Educational Strategies Wisconsin Medical Society
Understanding Coding & Reimbursement for SBI Presented By: Jen Cohrs CPC, CPMA, CGIC Director of Educational Strategies Wisconsin Medical Society CPT codes, descriptions and material only are Copyright
More informationCoding and Reimbursement: Crossroads and Opportunities
Coding and Reimbursement: Crossroads and Opportunities Michigan Audiology Coalition October 18, 2013 Debbie Abel, Au.D. Senior Specialist, Practice Management Disclosure of relevant relationships for this
More informationPreventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals. Section 6 BENEFITS
The Affordable Care Act: A Working Guide for MCH Professionals Section 6 BENEFITS In addition to expanding access to affordable health coverage options, the Affordable Care Act (ACA) makes several changes
More informationHealth Insurance Coverage for Emergency Services
BILL: SB 516 The Florida Senate BILL ANALYSIS AND FISCAL IMPACT STATEMENT (This document is based on the provisions contained in the legislation as of the latest date listed below.) Prepared By: The Professional
More informationCollaborative Care Tips for Sustainability. Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative
Collaborative Care Tips for Sustainability Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative Teamwork Applies to Billing Too!!! Combine with other initiatives
More informationPhysician Quality Reporting System (PQRS)
Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier Implementation guide for registry-based reporting for the Hepatitis C (HCV) Measures Group 2015 1 Overview of PQRS 1,2 What
More informationSCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL
SCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL Section 2 Covered Services The School Health Services Program is a joint effort between the Colorado Department of Education and Department of Health Care
More informationHealth Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014
vhealth insurance exchanges Health Insurance Marketplace What to expect in 2014 What to expect in 2014 The basics of exchanges As part of the Affordable Care Act (ACA or health care reform law), starting
More information(3) The commercial HMO with the largest insured commercial, non-medicaid enrollment in the state (hereafter referred to as Commercial HMO ) and
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Center for Medicaid and CHIP Services SMDL # 12-003
More informationA Healthy Florida Works Program. Policy Proposal. The smart choice for individuals and businesses in Florida
A Healthy Florida Works Program Policy Proposal The smart choice for individuals and businesses in Florida TABLE OF CONTENTS Introduction Executive Summary Program Description 3 5 6 Coverage Population
More informationEssential Health Benefits Discussion
APPENDIX E National Conference of Insurance Legislators July 16, 2015 Essential Health Benefits Discussion Christopher S. Sears (317) 236-5891 sears@icemiller.com 1 Overview Affordable Care Act requires,
More informationHealth Care Reform. Frequently Asked Questions. June 2013
Health Care Reform Frequently Asked Questions June 2013 Frequently Asked Questions (FAQs) What is a health insurance marketplace or exchange? A marketplace, or exchange, is a website where you can shop
More informationInsurance Tips. Obtaining Services
Insurance Tips The information below is designed to provide an overview of how to obtain insurance coverage for speech-language pathology (speech therapy) and audiology services. The American Speech-Language-Hearing
More informationImplantable Bone Conduction Clinical Coverage Policy No: 1A-36 Hearing Aids (BAHA) Amended Date: October 1, 2015.
Implantable Bone Conduction Clinical Coverage Policy No: 1A-36 Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Conductive Hearing Loss... 1 1.2 Sensorineural Hearing Loss...
More informationPPACA, COMPLIANCE & THE USA MARKET
PPACA, COMPLIANCE & THE USA MARKET INTRODUCTION The USA healthcare market is the largest in the world followed by Switzerland and Germany It consists of broad services offered by various hospitals, physicians,
More informationCoding 101: The Basics. What precipitated this web seminar? Basics
Coding 101: The Basics Debbie Abel, Au.D. Director of Reimbursement American Academy of Audiology dabel@audiology.org What precipitated this web seminar? Questions that are posed to the Academy Concern
More informationAmbulatory patient services (outpatient care you get without being admitted to a hospital)
What is the Affordable Health Care Act (ObamaCare)? Whether you need health coverage or have it already, the health care law offers new rights and protections that make coverage fairer and easier to understand.
More informationA Consumer s Guide to the Affordable Care Act
A Consumer s Guide to the Affordable Care Act The Affordable Care Act was designed to help make health care affordable for everyone. This guide will help you understand how the ACA affects individuals
More informationNebraska Health Insurance Exchange Update
Nebraska Health Insurance Exchange Update State of Nebraska s Health Insurance Exchange A Presentation to Advocacy Groups August 2012 TODAY'S AGENDA Section 1: Overview of Health Insurance Exchanges Section
More informationTransitioning from ICD-9-CM to ICD-10-CM. Tidewater Physicians Multispecialty Group Williamsburg, VA
Transitioning from ICD-9-CM to ICD-10-CM Tidewater Physicians Multispecialty Group Williamsburg, VA February 22, 2014 Our Agenda Some guidelines for this morning s presentation Our Transformational Point
More informationAffordable Care Act and Adolescents and Young Adults
Affordable Care Act and Adolescents and Young Adults Overview of Summit Welcome and Introductions Affordable Care Act 101 Affordable Care Act and Impact on Adolescents and Young Adults Federal Update on
More informationPresented by South Dakota Community Action Partnership
Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for
More informationFAQs on Billing for Health and Behavior Services
FAQs on Billing for Health and Behavior Services by Government Relations Staff January 29, 2009 Practicing psychologists are eligible to bill for applicable services and receive reimbursement from Medicare
More informationA Professional Practice Profile for Hearing Health Professionals
A Professional Practice Profile for Hearing Health Professionals Hearing instrument dispensing includes several professions that overlap. There are traditional hearing aid dispensers, board certified hearing
More informationPSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING
Status Active Medical and Behavioral Health Policy Section: Behavioral Health Policy Number: X-45 Effective Date: 01/22/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members
More informationProvider Handbooks. Vision and Hearing Services Handbook
Provider Handbooks January 2016 Vision and Hearing Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health
More informationMaryland s New Health Insurance Marketplace. What You Need To Know About Getting Health Coverage
Maryland s New Health Insurance Marketplace What You Need To Know About Getting Health Coverage Goals Today The Importance of Coverage What is Maryland Health Connection? New coverage options Qualified
More informationInformational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions.
Informational Series Glossary of Health Insurance & Medical Terminology How to use this glossary This glossary has many commonly used terms, but isn t a full list. These glossary terms and definitions
More informationHealth Insurance for Autism Spectrum Disorders in Nebraska
Health Insurance for Autism Spectrum Disorders in Nebraska What Parents and Service Providers Need to Know about the Nebraska Autism Insurance Law Mike Wasmer Director, State Government Affairs Autism
More informationEffective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014.
As part of our ongoing initiative to provide added value to our customers, this health care reform summary is being provided on an information only basis. This is NOT a legal document and is not intended
More informationCQMs. Clinical Quality Measures 101
CQMs Clinical Quality Measures 101 BASICS AND GOALS In the past 10 years, clinical quality measures (CQMs) have become an integral component in the Centers for Medicare & Medicaid Services (CMS) drive
More informationHEALTH REFORM and VACCINES: Review of Federal Legislation
HEALTH REFORM and VACCINES: Review of Federal Legislation The Patient Protection and Affordable Care Act (PPACA) And The Health Care and Education Reconciliation Act Alexandra Stewart June 2, 2012 1 Presentation
More informationICD-10-CM Training Module for Dental Practitioners. Presented by Workgroup for Electronic Data Interchange
ICD-10-CM Training Module for Dental Practitioners Presented by Workgroup for Electronic Data Interchange Disclaimer This presentation is for discussion and educational purposes only and is not intended
More informationComments and Responses Regarding Draft Local Coverage Determination: Outpatient Physical and Occupational Therapy Services
Comments and Responses Regarding Draft Local Coverage Determination: Outpatient Physical and Occupational Therapy Services As an important part of Medicare Local Coverage Determination (LCD) development,
More informationOhio Health Benefits LLC. Your health insurance partner!!
December 16, 2014 Presented by Steve Clark & Scott Prior Patient Protection and Affordable Care Act of 2010 Obamacare or ACA or PPACA or Health Care Reform (HCR) Signed in to law on March 23, 2010 The
More informationNCAHR 2015 Hearing Rehab Conference I n f o r m a t i o n U p d a t e d 0 2 / 2 6 / 1 5
[Return to NCAHR home page] NCAHR 2015 Hearing Rehab Conference I n f o r m a t i o n U p d a t e d 0 2 / 2 6 / 1 5 See Agenda; Presenters' Disclosures/Backgrounds; Learning Outcomes; & Session Topic Descriptions
More informationSTAYING AHEAD OF THE PACK: EMERGING TRENDS & ISSUES HEALTH CARE REFORM A POTENTIAL PLAYGROUND FOR FRAUD
STAYING AHEAD OF THE PACK: EMERGING TRENDS & ISSUES HEALTH CARE REFORM A POTENTIAL PLAYGROUND FOR FRAUD With the upcoming Health Care Reform Act, health care fraudsters will be using new tactics to defraud
More informationHealth Care Law Implementation: What Nonprofits Need to Know WELCOME!
Health Care Law Implementation: What Nonprofits Need to Know WELCOME! Health Care Law Implementation: What Nonprofits Need to Know (PPACA) Health Care Law Implementation: What Nonprofits Need to Know Heather
More informationSimple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future.
Simple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future. If you have any questions, please contact: Health Reform: A Guide
More informationHow Health Reform Will Help Children with Mental Health Needs
How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the
More informationAUDIOLOGY AND SPEECH PATHOLOGY What can I do with this degree?
AUDIOLOGY AND SPEECH PATHOLOGY What can I do with this degree? STRATEGIES/INFORMATION SPEECH-LANGUAGE PATHOLOGY Speech-language pathologists assess and treat patients who have speech, language, voice,
More informationHCR 101: Your Guide to Understanding Healthcare Reform
HCR 101: Your Guide to Understanding Healthcare Reform Are You Ready for Healthcare Reform? By now, you ve probably been hearing a lot about the Affordable Care Act (also known as healthcare reform or
More information5557 FAQs & Definitions
5557 FAQs & Definitions These Questions and Answers are intended to present information that has been acquired as part of the discovery process and provides necessary context for the Policy Directives
More informationCPT Coding Update And Other Issues
CPT Coding Update And Other Issues Robert E. Smith, M.D. Alison Lynch, M.D. November 13, 2013 1 Disclaimer This information is for educational and informational purposes only, and represents the understanding
More information